Abstract
Calcification of the aorta is a complex and long term disease process manifesting in ulcers, aneurysms, and abnormal thrombus formation. Similar to coronary atherosclerosis and valvular atherosclerosis, traditional cardiovascular risk factors are responsible for the development of aortic calcification. Large cohort databases, such as MESA and familial hypercholesterolemia cohorts are instrumental in defining the risk factors, progression and calcification phenotype in this large vessel. To date, no medical therapy has been defined to treat or slow progression, in part due to the complexity and length of time to develop this disease process. This chapter may help to understand the complexity and to help provide the foundation for future studies to determine if and when medical therapy may be instituted to slow progression of disease.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Takasu J, Katz R, Nasir K, et al. Relationships of thoracic aortic wall calcification to cardiovascular risk factors: the multi-ethnic study of atherosclerosis (MESA). Am Heart J. 2008;155:765–71.
Budoff MJ, Nasir K, Katz R, et al. Thoracic aortic calcification and coronary heart disease events: the multi-ethnic study of atherosclerosis (MESA). Atherosclerosis. 2011;215:196–202.
Hyder JA, Allison MA, Wong N, et al. Association of coronary artery and aortic calcium with lumbar bone density: the MESA Abdominal Aortic Calcium Study. Am J Epidemiol. 2009;169:186–94.
Demer LL, Tintut Y. Inflammatory, metabolic, and genetic mechanisms of vascular calcification. Arterioscler Thromb Vasc Biol. 2014;34:715–23.
Alrasadi K, Alwaili K, Awan Z, Valenti D, Couture P, Genest J. Aortic calcifications in familial hypercholesterolemia: potential role of the low-density lipoprotein receptor gene. Am Heart J. 2009;157:170–6.
Kindi MA, Belanger AM, Sayegh K, et al. Aortic calcification progression in heterozygote familial hypercholesterolemia. Can J Cardiol. 2017;33:658–65.
Rajamannan NM, Subramaniam M, Rickard D, et al. Human aortic valve calcification is associated with an osteoblast phenotype. Circulation. 2003;107:2181–4.
Boyden LM, Mao J, Belsky J, et al. High bone density due to a mutation in LDL-receptor-related protein 5. N Engl J Med. 2002;346:1513–21.
Gong Y, Slee RB, Fukai N, et al. LDL receptor-related protein 5 (LRP5) affects bone accrual and eye development. Cell. 2001;107:513–23.
Fujino T, Asaba H, Kang MJ, et al. Low-density lipoprotein receptor-related protein 5 (LRP5) is essential for normal cholesterol metabolism and glucose-induced insulin secretion. Proc Natl Acad Sci U S A. 2003;100:229–34.
Babij P, Zhao W, Small C, et al. High bone mass in mice expressing a mutant LRP5 gene. J Bone Miner Res. 2003;18:960–74.
Westendorf JJ, Kahler RA, Schroeder TM. Wnt signaling in osteoblasts and bone diseases. Gene. 2004;341:19–39.
Holmen SL, Giambernardi TA, Zylstra CR, et al. Decreased BMD and limb deformities in mice carrying mutations in both Lrp5 and Lrp6. J Bone Miner Res. 2004;19:2033–40.
Awan Z, Denis M, Bailey D, et al. The LDLR deficient mouse as a model for aortic calcification and quantification by micro-computed tomography. Atherosclerosis. 2011;219:455–62.
Rajamannan NM. The role of Lrp5/6 in cardiac valve disease: experimental hypercholesterolemia in the ApoE−/− /Lrp5−/− mice. J Cell Biochem. 2011;112:2987–91.
Rajamannan NM. Atorvastatin attenuates bone loss and aortic valve atheroma in LDLR mice. Cardiology. 2015;132:11–5.
Rajamannan NM. Calcific aortic valve disease in familial hypercholesterolemia: the LDL-density-gene effect. J Am Coll Cardiol. 2015;66:2696–8.
ten Kate GJ, Bos S, Dedic A, et al. Increased aortic valve calcification in familial hypercholesterolemia: prevalence, extent, and associated risk factors. J Am Coll Cardiol. 2015;66:2687–95.
Rajamannan NM. Oxidative-mechanical stress signals stem cell niche mediated Lrp5 osteogenesis in eNOS(−/−) null mice. J Cell Biochem. 2012;113:1623–34.
Chan KL, Teo K, Dumesnil JG, Ni A, Tam J, Investigators A. Effect of Lipid lowering with rosuvastatin on progression of aortic stenosis: results of the aortic stenosis progression observation: measuring effects of rosuvastatin (ASTRONOMER) trial. Circulation. 2010;121:306–14.
Cowell SJ, Newby DE, Prescott RJ, et al. A randomized trial of intensive lipid-lowering therapy in calcific aortic stenosis. N Engl J Med. 2005;352:2389–97.
Grenon SM, Lachapelle K, Marcil M, Omeroglu A, Genest J, de Varennes B. Surgical strategies for severe calcification of the aorta (porcelain aorta) in two patients with homozygous familial hypercholesterolemia. Can J Cardiol. 2007;23:1159–61.
Primary P, Genest J, Hegele RA, et al. Canadian Cardiovascular Society position statement on familial hypercholesterolemia. Can J Cardiol. 2014;30:1471–81.
Rajamannan NM, Nattel S. Aortic vascular calcification: cholesterol lowering does not reduce progression in patients with familial hypercholesterolemia- or does it? Can J Cardiol. 2017;33:594–6.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Rajamannan, N.M. (2018). Osteocardiology: Calcific Aortic Disease. In: Osteocardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-64994-8_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-64994-8_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-64993-1
Online ISBN: 978-3-319-64994-8
eBook Packages: MedicineMedicine (R0)